Abstract:
OBJECTIVE:To assess the efficacy and safety of an oral formulation of tranexamic acid for the treatment of heavy menstrual bleeding. METHODS:Adult women with heavy menstrual bleeding (mean menstrual blood loss 80 mL or more per cycle) were enrolled in a double-blind, placebo-controlled study. After two pretreatment menstrual cycles, women were randomized to receive tranexamic acid 3.9 g/d or placebo for up to 5 days per menstrual cycle through six cycles. To meet the prespecified three-component primary efficacy end point, mean reduction in menstrual blood loss from baseline with tranexamic acid treatment needed to be 1) significantly greater than placebo, 2) greater than 50 mL, and 3) greater than a predetermined meaningful threshold (36 mL or higher). Health-related quality of life was measured using a validated patient-reported outcome instrument. RESULTS:Women who received tranexamic acid (n=115) met all three primary efficacy end points: first, a significantly greater reduction in menstrual blood loss of -69.6 mL (40.4%) compared with -12.6 mL (8.2%) in the 72 women who received placebo (P<.001); reduction of menstrual blood loss exceeding a prespecified 50 mL; and last, reduction of menstrual blood loss considered meaningful to women. Compared with women receiving placebo, women treated with tranexamic acid experienced significant improvements in limitations in social or leisure and physical activities, work inside and outside the home, and self-perceived menstrual blood loss (P<.01). The majority of adverse events were mild to moderate in severity, and the incidence of gastrointestinal adverse events was comparable with placebo. CONCLUSION:In this study, a new oral tranexamic acid treatment was well tolerated and significantly improved both menstrual blood loss and health-related quality of life in women with heavy menstrual bleeding. CLINICAL TRIAL REGISTRATION:ClinicalTrials.gov, www.clinicaltrials.gov, NCT00386308. LEVEL OF EVIDENCE:I.
journal_name
Obstet Gynecoljournal_title
Obstetrics and gynecologyauthors
Lukes AS,Moore KA,Muse KN,Gersten JK,Hecht BR,Edlund M,Richter HE,Eder SE,Attia GR,Patrick DL,Rubin A,Shangold GAdoi
10.1097/AOG.0b013e3181f20177subject
Has Abstractpub_date
2010-10-01 00:00:00pages
865-875issue
4eissn
0029-7844issn
1873-233Xpii
00006250-201010000-00012journal_volume
116pub_type
杂志文章,多中心研究,随机对照试验abstract:BACKGROUND:Functional ovarian cysts are a common gynecological problem among women of reproductive age worldwide. When large, persistent, or painful, these cysts may require operations, sometimes resulting in removal of the ovary. Since early oral contraceptives were associated with a reduced incidence of functional ov...
journal_title:Obstetrics and gynecology
pub_type: 评论,杂志文章
doi:10.1097/AOG.0b013e3181b5a547
更新日期:2009-09-01 00:00:00
abstract::Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks ...
journal_title:Obstetrics and gynecology
pub_type: 共识发展会议,杂志文章
doi:10.1097/AOG.0000000000001483
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVE:To investigate factors associated with differential state maternal mortality ratios and to quantitate the contribution of various demographic factors to such variation. METHODS:In a population-level analysis study, we analyzed data from the Centers for Disease Control and Prevention National Center for Healt...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,收录出版
doi:10.1097/AOG.0000000000001628
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVE:To compare the safety and efficacy of intravaginal misoprostol versus intravenous (IV) oxytocin infusion for labor induction. METHODS:One hundred thirty patients were randomly assigned to one of two induction groups: 1) intravaginal misoprostol or 2) IV oxytocin by continuous infusion, with prior cervical ri...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1993-03-01 00:00:00
abstract::This report describes an innovative use of videography in teaching retropubic space anatomy and surgery. After the standard abdominal incision has been made, the second surgical assistant places a gynecologic laparoscope, fitted with an endoscopic camera, into the retropubic space and guides the laparoscope documentin...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-04-01 00:00:00
abstract::This study was conducted to evaluate the prevalence of transient hyperprolactinemia in infertile women with luteal phase deficiency. One hundred fifty-one luteal phase deficiency patients and 11 controls had serum prolactin (PRL) measured daily for 3-4 days near ovulation. Thirty-three subjects (21.9%) had transient h...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1991-10-01 00:00:00
abstract::A simple, inexpensive enzyme-linked immunosorbent assay using commercially available supplies is described. An examination of amniotic fluid alpha-fetoprotein (AFP) values for 15 to 20 weeks' gestation is presented. The interassay coefficient of variation was 12% (N = 40) at a level of 4.75 micrograms/mL. Repeat freez...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-09-01 00:00:00
abstract:OBJECTIVE:To determine the efficacy, safety, and duration of induced labor using an integrative approach (prostaglandin, amniotomy, oxytocin) and to depict these findings graphically. METHODS:Five hundred ninety-seven pregnancies requiring induction of labor between October 1993 and May 1995 were analyzed prospectivel...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/S0029-7844(97)00259-7
更新日期:1997-08-01 00:00:00
abstract::To evaluate the effectiveness of a physician-based intervention to promote smoking cessation during pregnancy, we conducted this randomized controlled trial in the resident-staffed prenatal clinics at the University of North Carolina Women's Hospital . Two hundred fifty prenatal patients who smoked were enrolled at th...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0029-7844(95)00492-0
更新日期:1996-04-01 00:00:00
abstract:OBJECTIVE:To evaluate whether myo-inositol supplementation, an insulin sensitizer, reduces the rate of gestational diabetes mellitus (GDM) and lowers insulin resistance in obese pregnant women. METHODS:In an open-label, randomized trial, myo-inositol (2 g plus 200 micrograms folic acid twice a day) or placebo (200 mic...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,随机对照试验
doi:10.1097/AOG.0000000000000958
更新日期:2015-08-01 00:00:00
abstract:BACKGROUND:A pregnancy with Gorham disease (massive osteolysis syndrome) is described. To our knowledge, this is the first reported case of a pregnancy associated with this disease. CASE:A 25-year-old woman was seen for pre-conception counseling with the diagnosis of Gorham disease. Before pregnancy, magnetic resonanc...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-05-01 00:00:00
abstract::Nonradioisotopic enzyme assays have been developed to detect the preovulatory luteinizing hormone (LH) surge in the unextracted urine of normally menstruating women. The amino groups on 6-mm glass beads were activated and coupled to the anti-LH-gamma-globulin for enzyme immunoassay or to the LH receptor prepared from ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract::Two patients with severe postpartum hemorrhage refused blood product transfusion for religious reasons. The patients' hemoglobin level had dropped to 3.0% or less after operative intervention, and the cardiac indexes on transfer to the tertiary care center were 8.0 and 7.3 L/minute per m2, respectively. Each received ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::The application of sophisticated anaerobic technology coupled with culdocentesis has radically altered out concepts of endometritis-salpingitis-peritonitis (ESP). The demonstration of a polymicrobial predominantly anaerobic peritonitis in selected cases of ESP polarized conceptual thought into gonococcal and nongonoco...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1097/00006250-198003001-00039
更新日期:1980-05-01 00:00:00
abstract::Rupture of a splenic artery aneurysm is an uncommon occurrence but carries a high maternal and fetal mortality rate. This article presents the seventh case of both maternal and fetal survival and discusses some features salient to spontaneous rupture of a splenic artery aneurysm. ...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1986-02-01 00:00:00
abstract::The recently developed sperm penetration assay (SPA) tests the functional capacity of sperm. It is based upon the ability of in vitro capacitated human spermatozoa to penetrate zona-free hamster eggs in vitro. The SPA was superior to seminal fluid analysis in predicting both fertility and infertility; in the predictio...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1981-05-01 00:00:00
abstract:OBJECTIVE:To determine whether obstetric admissions to the intensive care unit (ICU) are useful quality-assurance indicators. METHODS:We analyzed retrospectively obstetric ICU admissions at two tertiary care centers from 1991 to 1997. RESULTS:The 131 obstetric admissions represented 0.3% of all deliveries. The majori...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(99)00274-4
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVE:In 2014, the Society for Maternal-Fetal Medicine, the Eunice Kennedy Shriver National Institute of Child Health and Human Development, the American Academy of Pediatrics, and the American College of Obstetricians and Gynecologists published an executive summary of a joint workshop to establish obstetric inter...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0000000000003106
更新日期:2019-03-01 00:00:00
abstract::Danazol is a synthetic steroid with antigonadotropic properties useful in treating endometriosis, especially in young infertile women. Prior to its availability for clinical use in September 1976, thyroid function studies other than thyroid-stimulating hormone (TSH), which was normal, had not been reported. Soon after...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/00006250-198003000-00028
更新日期:1980-03-01 00:00:00
abstract:OBJECTIVE:To clarify whether there are susceptible HLA-DQB1 or HLA-DPB1 alleles in women with preeclampsia. METHODS:The frequency of HLA-DQB1 and HLA-DPB1 alleles was analyzed in 47 women with previous severe preeclampsia and compared with that in 85 normal fertile women. The types of HLA-DQB1 and HLA-DPB1 alleles wer...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(00)00918-2
更新日期:2000-09-01 00:00:00
abstract::For more than 30 years the collaboration between obstetrician-gynecologists and certified nurse-midwives at San Francisco General Hospital has led to the provision of high-quality care to women and families. This enduring partnership has been sustained by shared goals and values, most notably a commitment to excellenc...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/AOG.0b013e3182297d2d
更新日期:2011-09-01 00:00:00
abstract::To examine the accuracy and predictability of human chorionic gonadotropin concentrations in determining gestational age, serum concentrations of human chorionic gonadotropin (beta-subunit) were measured during the first 157 days after last menses. Using the regression curve generated, human chorionic gonadotropin con...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1983-07-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine whether the placental transfer of interleukin (IL)-1alpha, IL-6, and tumor necrosis factor-alpha (TNF-alpha) occurs. METHODS:Four normal-term placentas were perfused for maternal-fetal transfer of the cytokines, 2 placentas for fetal-maternal transfer, and 4 additio...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1097/01.AOG.0000114980.40445.83
更新日期:2004-03-01 00:00:00
abstract::Placenta accreta in association with placenta previa and previous cesarean delivery is a condition of increasing clinical significance. A case report of a woman with placenta percreta is presented. Risk factors, incidence, and management are discussed. Recommendations for preoperative and intraoperative management are...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1987-03-01 00:00:00
abstract::Laparoscopy was used to evaluate 100 women who consistently reported pelvic pain in the same location for a minimum of six months. These findings were compared with those of 50 asymptomatic women who underwent laparoscopy for tubal ligation. Overall, 83% of the group with pelvic pain had abnormal pelvic organs as comp...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1984-11-01 00:00:00
abstract:OBJECTIVES:To investigate the sensitivity of immunoblotting and enzyme-linked immunosorbent assay (ELISA) to detect autoantibodies to bullous pemphigoid antigen 180 in patients with pemphigoid gestationis and to correlate autoantibody serum levels with disease activity. METHODS:In serum samples obtained from 44 pregna...
journal_title:Obstetrics and gynecology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.AOG.0000115506.76104.ad
更新日期:2004-04-01 00:00:00
abstract:BACKGROUND:Laparoscopic cholecystectomy is becoming a popular surgical option in the management of gallstone disease. Reports on complications of this procedure have usually focused on prolonged operative time, bleeding, and infections. We describe a case of cholelithiasis of the ovary following laparoscopic cholecyste...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
abstract:BACKGROUND:Only one case of plasma cell cervicitis, a rare variant of chronic cervicitis, has been reported. We report a second case and present data supporting the detection of human papillomavirus (HPV) outside of epithelial tissues. CASE:A 67-year-old woman was found to have a large cervical tumor. Extensive diagno...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
abstract:OBJECTIVE:To study the survival, rates and patterns of recurrence, and perioperative morbidity in medically compromised women with endometrial cancer treated by primary vaginal hysterectomy. METHODS:Fifty-one patients with endometrial cancer treated initially by vaginal hysterectomy between 1977 and 1999 were identifi...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:
更新日期:2001-05-01 00:00:00
abstract:OBJECTIVE:To describe episiotomy usage at vaginal delivery in the United States from 1979-1997. METHODS:We used the National Hospital Discharge Survey, a federal database of a national sample of inpatient hospitals. Data from 1979 to 1997 were analyzed using International Classification of Diseases, Ninth Revision, Cl...
journal_title:Obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0029-7844(02)02449-3
更新日期:2002-12-01 00:00:00